Inspection on 31/01/07 for The Cedars

This inspection was carried out on 31st January 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Cedars 25/10/07

The Cedars 12/06/06

The Cedars 17/03/06

The Cedars 02/11/05

The Cedars 25/02/05

The Cedars 17/08/04

The Cedars 24/02/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Cedars (The) Angel Lane Shaftesbury Dorset SP7 8DF Lead Inspector Gloria Ashwell Key Unannounced Inspection 31st January 2007 12:15 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address DS0000020499.V329001.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. DS0000020499.V329001.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cedars (The) Address Angel Lane Shaftesbury Dorset SP7 8DF Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01747 852860 01747 852722 The Community Health Association of Shaftesbury Limited Mrs Julie Elizabeth Gaskell-Sykes Care Home 26 Category(ies) of Dementia - over 65 years of age (26), Old age, registration, with number not falling within any other category (26) of places DS0000020499.V329001.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th June 2006 Brief Description of the Service: The Cedars is a converted and extended detached premises close to the centre of Shaftesbury providing accommodation for 26 residents. The home is registered to provide nursing and social care to older people, including those with dementia type illnesses. The Cedars is owned by the Community Health Association of Shaftesbury; a charitable company limited by guarantee. Ownership of the home is represented by a Board of Trustees. Since the previous inspection Mrs Julie Gaskell-Sykes has become the registered manager. Laundering of clothing and household linen is carried out at the home and arrangements can be made for chiropodists, opticians and other health and social care professionals to visit individual residents. The home has a fully enclosed courtyard style garden, an open garden to one side and car parking at the front of the home. The home is located in the centre of Shaftesbury, close to shops and other amenities including bus services. Fees are charged weekly and at present range between £550 and £683 per person. For respite care these charges are raised by £100 per week. Information regarding the subjects Value for Money and Fair Terms in Contracts can be obtained from the web link: www.oft.gov.uk A report entitled Care Homes in the UK - A Market Study is available on web link http:/www.oft.gov.uk/NR/rdonlyres/5362CA9D-764D-4636-A4B1-A65A7AFD347B/0/oft780.pdf DS0000020499.V329001.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was a statutory inspection required in accordance with the Care Standards Act 2000. The inspection was unannounced; the inspector spoke with the registered manager and training coordinator, examined records and during her tour of the premises spoke to residents and staff. During the inspection, particular residents were ‘case tracked’; for example, for evidence regarding Standards 3, 7 and 8, records relating to the same resident were examined, and the resident spoken with. Additional information used to inform the inspection process included the monthly reports regularly sent to the Commission by the provider organisation. During this inspection compliance with all key standards of the National Minimum Standards was assessed. What the service does well: The home provides very nursing care to residents in comfortable and suitably equipped premises. Residents are satisfied with The Cedars; comments included “They look after us very well”. Within the limitation of their abilities residents are assisted to maintain as much independence as possible and are encouraged to maintain contact with the local community. Meals are appetising and of good quantity and quality. Medicines prescribed by doctors are safely stored and carefully administered to residents by trained nurses. DS0000020499.V329001.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. DS0000020499.V329001.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000020499.V329001.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (The home does not provide intermediate care so Standard 6 does not apply) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents (or their representatives) are provided with information about The Cedars and are encouraged to visit in advance of admission to establish their impressions of life at the home and the standard of available accommodation. Prior to admission, the needs of each proposed resident are assessed and the home then writes to prospective residents confirming the ability to properly care for them. EVIDENCE: The records of a recently admitted resident included details of pre-admission assessment which had been carried out by the registered manager when she visited the prospective resident at a previous address. DS0000020499.V329001.R01.S.doc Version 5.2 Page 9 In advance of making the decision to enter the home the closest relatives of the prospective resident visited The Cedars to view the premises on behalf who was too frail to do this in person. DS0000020499.V329001.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of care is good and in accordance with a written plan of care for each resident ensuring that staff have sufficient information upon which to base their care practice. Residents with complex health needs including wound management receive good nursing care. All accidents are investigated and periodically audited to minimise risks of recurrence. Medicines prescribed by doctors are safely stored and carefully administered to residents by staff trained in this work, thereby protecting residents from medicine errors. Residents receive prescribed medicines at the correct times and in correct amounts. Residents wishing to do so can manage their own medicines. Residents are treated with respect and their privacy and dignity is protected at all times. DS0000020499.V329001.R01.S.doc Version 5.2 Page 11 EVIDENCE: Residents believe they are properly cared for; comments received from residents during the inspection included “They look after us very well”. Since the last inspection a new system of assessment and care planning documentation has been introduced. Care records of 4 residents were examined and contained risk assessments forming the basis for care plans and daily records describing the care of each resident. Staff said they find the new system very clear and easy to use, and are confident it provides them with comprehensive and up to date information. Records are kept of all accidents and include clear and comprehensive details of investigation and consequent actions to minimise risks of recurrence. Medication administration records are properly kept indicating that residents receive prescribed medicines at the correct times and in correct amounts those wishing to do so can manage their own medicines in accord with a risk assessment process; none of the currently accommodated residents have chosen to manage their own medicines. The handling of medicines is carried out by trained nurses. The home carried out a recent audit of medicines held by the home and identified that a number of tablets appeared to be missing. The home took prompt and appropriate action to inform the Commission and the dispensing pharmacist and instigated investigation. The reason for the apparently missing medicines remains unknown but it is not considered likely that any criminal action (i.e. theft) has taken place. In the presence of staff residents appeared relaxed, confident and at ease; staff interactions with residents were of a friendly and considerate manner. DS0000020499.V329001.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The quality of daily life in the home is good with residents assisted to maintain as much independence as possible. Social and leisure activities are suited to the preference and ability of each resident. Residents are encouraged to maintain contact with the local community and visits by their friends and relatives are welcomed by the home. Meals are appetising and of good quantity and quality. A combined lounge/dining room is available on each of the two floors but most residents take meals in their bedrooms. EVIDENCE: The inspector visited a number of residents including many who were very frail and unable to reliably communicate; all those able to express an opinion indicated satisfaction with the range of activities, meal provision, and premises. DS0000020499.V329001.R01.S.doc Version 5.2 Page 13 The home employs an Activity Organiser; in accordance with a recommendation included in the report of the previous inspection her working hours have been increased. Visitors are welcome at any time and those present during the inspection said they are always made to feel welcome and placed at ease by the staff. Residents said they were satisfied with the quality, choice and quantity of food provided. There is a choice of main courses available for the midday meal; one resident said that the range of choices was good. On the ground floor there is a large combined lounge/dining room but due to the severe frailties of most residents currently accommodated the dining room facility of this room is rarely used at present. DS0000020499.V329001.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home adheres to a policy/procedure for the prevention of abuse and all staff have received training in the understanding and prevention of abuse to ensure that they remain vigilant to protect vulnerable residents from such risks. The complaints procedure provides information on the procedure to follow to persons wishing to make complaint and service users know how to complain. EVIDENCE: Residents feel confident that if they had concerns or complaints they will be listened to and taken seriously. To ensure residents and their representatives have access to the complaints procedure it is included in the service user guide to the home and a copy is provided to each residents’ relative/representative. Residents know how to complain and feel confident that if they had concerns or complaints they will be listened to and taken seriously. The home keeps records of all complaints received and investigated. Since the last inspection no complaints against the home have been received or investigated. DS0000020499.V329001.R01.S.doc Version 5.2 Page 15 The home has developed and implemented written policies and procedures for the protection of residents from abuse or neglect and provides all staff with training in the understanding of abuse and their role in protecting residents from abuse in its many forms, including neglect. DS0000020499.V329001.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is very good. This judgement has been made using available evidence including a visit to this service. The Cedars is a well-appointed and comfortable home, providing a safe and comfortable environment for residents and staff. On the day of inspection the home was clean, pleasant and hygienic and there was evidence indicating that this is the usual standard of provision, which protects service users from risks of infection. EVIDENCE: The Cedars is a partly traditionally built house, and partly purpose built extension. It offers compact bedrooms, bathrooms equipped for the use of persons requiring assistance and a communal room on each of the two floors. DS0000020499.V329001.R01.S.doc Version 5.2 Page 17 Since the last inspection the ground floor lounge/dining room has become the main communal room of the home, used by residents of both floors; a smaller first floor room is available as a ‘quiet room’ for the use of residents preferring to remain apart from the main activities of the home, and is also used as a training room for staff. Also since the last inspection a ramp has been provided to enable ease of access to the garden from the ground floor lounge by persons with poor mobility and/or requiring the use of wheelchairs. On the day of inspection the home was clean, tidy and comfortable throughout; there were no unpleasant odours. DS0000020499.V329001.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home employs enough staff to meet the needs of residents and to ensure their safety and comfort and maintenance of the good condition of the premises. Recruitment practices ensure the protection of residents from potentially unsuitable staff. Staff receive appropriate training and are competent to carry out their jobs. EVIDENCE: Staffing levels are provided in accordance with the assessed needs of residents to ensure that at all times sufficient staff are available to properly meet their needs. Since the previous inspection an additional work session has been provided to the Activities Organiser enabling her to provide more social and recreational activities, and consequently reducing the necessity for care staff involvement at these times. DS0000020499.V329001.R01.S.doc Version 5.2 Page 19 All staff spoken with during the inspection were enthusiastic about their work and felt that they provided a good standard of care to residents and are properly supported by the management and training provision. The records of two recently employed staff members were examined and found to contain all essential information including written references, an interview assessment, health details, evidence of identity and of induction training. Criminal Records Bureau (CRB) disclosures are obtained for all staff in advance of employment. There is an enthusiastic approach to staff training; regular training days are arranged and all staff are required to undertake (and as necessary update) training in core subjects including fire safety, moving and handling, food hygiene and emergency aid. The home exceeds the standard for at least 50 of the care staff to hold a National Vocational Qualification in care, or an equivalent care-based qualification. DS0000020499.V329001.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and suitably staffed, is much liked by residents and their representatives and provides a good quality of life. Residents are satisfied with the home and feel staff care for them well and put them at their ease. The home does not manage the finances of residents. The premises and equipment are properly maintained in good condition. DS0000020499.V329001.R01.S.doc Version 5.2 Page 21 EVIDENCE: Since the previous inspection Mrs Julie Gaskell-Sykes has become the registered manager of the home; she is a trained nurse who has been employed at The Cedars for many years and throughout that time has been an experienced and respected senior member of the staff. The home has ongoing systems for quality assurance; satisfaction surveys are periodically issued. To ensure continuity of approach the home operates in accord with a selection of policy and procedure documents. With the exception of safe keeping some amounts of cash (for which all transactions are confirmed by receipt), the home does not manage the finances of residents. Staff trained in First Aid are on duty in the home at all times. All staff are supervised and each has a personal profile containing records of appraisal and training. Details of equipment servicing and maintenance were provided to the Commission in advance of the last inspection. Regular checks/tests of fire alarms are carried out and recorded and a system is being developed for periodic in-house checks/tests of emergency lighting and extinguishers, to ensure the correct functioning of this emergency equipment. The home has commenced recording of a Health & Safety risk assessment of the premises and working practices; the inspector provided advice on the areas for which this should be expanded to ensure all foreseeable and known risks are included, and the means of managing them. DS0000020499.V329001.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 DS0000020499.V329001.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations DS0000020499.V329001.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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